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​Patient Bill of Rights

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​The patient and family have the right to considerate and respectful care.

The patient and family have the right to obtain complete and current information concerning services provided, diagnosis, treatment, advance directives, and prognosis in terms they can be reasonably expected to understand.

The patient has the right to receive, from his/her physician information necessary to give informed consent prior to the start of any procedure and/or treatment. When the patient requests information concerning medical alternatives, the patient has the right to such information, and to know the name of the person responsible for the procedures and/or treatment.

The patient has the right to choose his/her attending physician.

The patient has the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of his/her action.

The patient has the right to every consideration of his/her privacy, confidentiality, and security concerning his/her own hospice care program.

The patient has the right to have his/her property respected.

The patient has the right to expect that all communications and records pertaining to his/her care should be treated as confidential.

The patient has the right to expect reasonable continuity of care.

The patient/family have the right to examine and receive an explanation of his/her financial responsibilities regardless of source of payment.

The patient has the right to be informed of the findings of assessment of physical, social, psychological, spiritual, economic and safety needs.

The patient has a right to have an individual plan of care including assessment, implementation and evaluation by the appropriate team member.

The patient has the right to participate, with family and team, in developing an individualized plan of care and when there is divergent thinking, an arena for further discussion can be provided. The Ethics Committee is a transdisciplinary group which can offer a confidential, nonjudgmental forum for reviewing and discussing ethical concerns. To report an ethics issue to the Ethics Committee, ask any hospice staff for a Request to Review form or after office hours call 440.942.6699 to request assistance.

The patient has the right to have care and teaching directed toward optimal quality of life in an environment that preserves dignity and contributes to a positive self-image.

The patient has the right to the proper identification of team members and to receive adequate information about the persons responsible for the delivery of his/her care, treatment, and services.

The patient has the right to expect that team members have current knowledge in their respective fields.

The patient has the right to appropriate assessment and to receive effective pain management and symptom management related to conditions of the serious illness.

The patient has the right to have his/her consent obtained for recording or filming made for purposes other than identification, diagnosis or treatment.

The patient has the right to unlimited contacts with visitors and others.

The patient has the right to be protected as a research subject and have his/her rights respected during research, investigation and clinical trials involving human subjects.

The patient and family has the right to file a grievance if they are not satisfied with their care or they have been discriminated against. They may call or write the Chief Strategy Officer or the Chief Executive Officer of Hospice of the Western Reserve at 216.383.2222. If their concerns are not resolved, they have the right to notify the Joint Commission for the Accreditation of Health Care Organization at 1.800.994.6610 and/or the Ohio Department of Health at 1.800.342.0553.

If a patient has been adjudged incompetent under state law by proper jurisdiction, the rights of the patient are exercised by the person appointed pursuant to state law to act on the patient's behalf.

If a state court has not adjudged a patient incompetent, any legal representative designated by the patient or in accordance with state law may exercise the patient's rights to the extent allowed by state law.

The patient has the right to be free from mistreatment, neglect or verbal, mental, sexual and physical abuse, including injuries of unknown source and free from restraint or seclusion and misappropriation of patient property.

Patient Responsibilities

I (we) have consented for hospice services from Hospice of the Western Reserve and agree to:

Participate in the development of my Plan of Care in conjunction with the hospice team, which includes the physician. Additionally, continuously discuss goals for my care, activities of daily living and quality of life.

Participate in the management of care that may involve personal care, treatments and medication adminstration.

Inform the hospice team of other agencies providing care and services to me.

Be at home and available for the visits scheduled with hospice team members. I understand that I may have to allow one half hour before and after the scheduled time to accommodate traffic, weather conditions and unforeseen events.

Notify the team if I need to cancel or change the time of the scheduled visit.

Submit requests for volunteer support no less than 72 hours in advance with the understanding that the team will make every attempt to fulfill my requests.

Resolve care issues through the hospice primary nurse. The team leader may be contacted at the designated team office for further assistance with the resolution.

Treat hospice caregivers with respect and courtesy, understanding that if they are not afforded such respect and courtesy, they will leave the home immediately. The subsequent visit will be scheduled with the assistance of the team leader.

Call the hospice team (if after hours, the on-call team) with any questions, change of condition or symptoms. Call Hospice of the Western Reserve rather than 911 for immediate assistance.

What are my financial responsibilities?

Costs which are not approved by Hospice of the Western Reserve and not in compliance with the agreed upon plan of care

Deductibles and co-payments

Care and treatment provided when no insurance coverage is available

Care and treatment not related to the serious illness

Room and board fees not covered by the third party payer

Any cost incurred for treatment with a physician and/or facility not contracted with Hospice of the Western Reserve

Hospice of the Western Reserve is a community-based 501(c)(3) non-profit hospice, tax ID: 34-1256377 Your donation is tax-deductible as permitted by law.

OUR MISSION

Hospice of the Western Reserve provides palliative and end-of-life care,
caregiver support, and bereavement services throughout Northern Ohio. In
celebration of the individual worth of each life, we strive to relieve
suffering, enhance comfort, promote quality of life, foster choice in
end-of-life care, and support effective grieving.

HEADQUARTERS

17876 St. Clair Avenue
Cleveland, Ohio 44110

MAIN LINE

800.707.8922

REFERRAL PHONE

216.383.3700

REFERRAL FAX

216.383.5298

Hospice of the Western Reserve is a community-based 501(c)(3) non-profit hospice, tax ID: 34-1256377 Your donation is tax-deductible as permitted by law.

OUR MISSION
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Hospice of the Western Reserve provides palliative and end-of-life care,
caregiver support, and bereavement services throughout Northern Ohio. In
celebration of the individual worth of each life, we strive to relieve
suffering, enhance comfort, promote quality of life, foster choice in
end-of-life care, and support effective grieving.